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Anaphylaxis admissions in pediatric intensive care units: follow up and risk of recurrence. Data about the risk of anaphylaxis recurrence in children are lacking. We assessed anaphylaxis recurrence and medical follow-up in a cohort of children previously hospitalized in a French pediatric intensive care unit (PICU) for anaphylaxis.We conducted a telephone survey of 166 children (≤18y) hospitalized from 2003 to 2013.In all, 106 (64%) completed the survey [boys, 59%; mean age (SD):15.3y (5.5 (...) )]. The main index triggers were drugs (45%) and foods (37%). The mean duration follow-up was of 7.7y (SD: 2.4). Thirty-eight (36%) children experienced 399 new allergic reactions during a follow-up period of 282 patient-years (incidence rate: 1.4/100 patients/year; 95% CI: 0.64-2.04). Twelve children experienced 19 anaphylaxis reactions including five requiring PICU admission (anaphylaxis recurrence rate: 0.20/100 patients/year; 95%CI non-calculable). Food was the trigger for 79% of recurrent reactions
Anaphylactic reaction caused by skin contact with disinfectant chloramine-T. 30552765 2019 02 19 1600-0536 2018 Dec 15 Contact dermatitis Contact Derm. Anaphylactic reaction caused by skin contact with the disinfectant chloramine-T. 10.1111/cod.13200 Roorda Berrit M BM Department of Dermatology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands. Nienhuis Hans L A HLA Department of Internal Medicine, University of Groningen, University Medical Centre (...) Groningen, Groningen, The Netherlands. Schuttelaar Marie L A MLA https://orcid.org/0000-0002-0766-4382 Department of Dermatology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands. eng Journal Article 2018 12 15 England Contact Dermatitis 7604950 0105-1873 CAS no. 7080-50-4 Halamid anaphylaxis case report chloramine-T contact urticaria disinfectant 2018 12 10 2018 12 13 2018 12 16 6 0 2018 12 16 6 0 2018 12 16 6 0 aheadofprint 30552765 10.1111/cod.13200
Analysis of Value-Based Costs of Undesignated School Stock Epinephrine Policies for Peanut Anaphylaxis. Children experiencing anaphylaxis at school may lack access to a personal epinephrine device, prompting recent legislation permitting undesignated (eg, non-student specific) stock epinephrine autoinjector units at school. However, epinephrine device costs vary, and the cost-effectiveness of undesignated school stock epinephrine is uncharacterized to date.To define value-based strategies
Contact urticaria with anaphylaxis to chlorocresol, chloroxylenol and thiourea. 30523628 2019 01 10 1600-0536 2018 Dec 06 Contact dermatitis Contact Derm. Contact urticaria with anaphylaxis caused by chlorocresol, chloroxylenol, and thiourea. 10.1111/cod.13194 Mehrtens Sarah H SH https://orcid.org/0000-0002-7335-6505 Department of Dermatology, Kent and Canterbury Hospital, East Kent Hospitals University NHS Foundation Trust, Canterbury, UK. Reckling Christine C https://orcid.org/0000-0002-7487 (...) -3563 Department of Dermatology, Kent and Canterbury Hospital, East Kent Hospitals University NHS Foundation Trust, Canterbury, UK. eng Journal Article 2018 12 06 England Contact Dermatitis 7604950 0105-1873 CAS no. 59-50-7 CAS no. 62-56-6 CAS no. 88-04-0 / 1321-23-9 anaphylaxis case report chlorocresol chloroxylenol contact urticaria thiourea 2018 09 06 2018 11 29 2018 11 30 2018 12 14 6 0 2018 12 14 6 0 2018 12 8 6 0 aheadofprint 30523628 10.1111/cod.13194
Emergency call characteristics and EMS dispatcher protocol adherence for possible anaphylaxis. Anaphylaxis is a medical emergency requiring prompt recognition and treatment with intramuscular epinephrine to optimize outcomes. To date, there is a paucity of data regarding the demographic characteristics of the subset of patients calling 9-1-1 for allergic reactions and the emergency medical services (EMS) dispatcher's adherence to national protocols for their response to a suspected allergic (...) Problems protocols. The calls were further reviewed for demographic characteristics, symptomatology, history of allergy, suspected trigger of the current reaction, and use and availability of medications. Calls were also classified as to whether the patient met criteria for anaphylaxis. We calculated frequencies for categorical measures and medians with ranges for continuous measures.A total of 146 calls met inclusion criteria. The median age of patients was 29 years (interquartile range 13, 52). 12.3
Clinical and demographic characteristics of fatal anaphylaxis in Spain (1998-2011): A comparison between a series from the hospital system and a national forensic series. Reports of fatal anaphylaxis remain scarce because of the rarity of the condition and the fact that information is limited to a few countries.Our objective was to investigate clinical and demographic characteristics and the causes of fatal anaphylaxis in Spain using two databases of cases of fatal anaphylaxis.We analysed fatal (...) anaphylaxis in a series from the Spanish hospital system and a series from the National Institute of Toxicology and Forensic Sciences (Instituto Nacional de Toxicología y Ciencias Forenses [INTCF]), which predominantly comprise extrahospital deaths. Deaths from the Spanish hospital system were retrieved from among all deaths occurring during 1998-2011 using codes related to anaphylaxis. Deaths due to anaphylaxis in the INTCF database during the same period were retrieved by 2 allergists, who identified
Adrenaline in the Acute Treatment of Anaphylaxis. Anaphylaxis is the most serious manifestation of an immediate allergic reaction and the most common emergency event in allergology. Adrenaline (epi- nephrine) is the mainstay of acute pharmacotherapy for this complication. Although epinephrine has been in use for more than a century, physicians and patients are often unsure and inadequately informed about its proper administration and dosing in everyday situations.This review is based (...) on pertinent publications from the period 1 January 2012 to 30 September 2017 that were retrieved, on the basis of the existing guide- lines of 2007 and 2014, by a PubMed search employing the keywords "anaphylaxis treatment," "allergic shock," "adrenaline," and "epinephrine," as well as on further ar- ticles from the literature.Adrenaline/epinephrine administration often eliminates all manifestations of anaphylaxis. The method of choice for administering it (except in intensive-care medicine
Human factors study of a newly approved prefilled syringe of epinephrine for the treatment of anaphylaxis. Epinephrine remains the treatment of choice for acute anaphylaxis. However, currently available autoinjectors are costly, and studies have demonstrated human factor issues that result in incorrect use as well as device failures.A recent U.S. Food and Drug Administration approved prefilled syringe of epinephrine for the treatment of anaphylaxis was examined in a prospective human factors (...) , 100% (82/82) completed category 3, 93% (71/76) completed category 4 (six participants were observed to have a device with a bent needle and were taken out of the analysis), and 99% (81/82) completed category 5.In this prospective study of human factors that effect correct epinephrine injection, a high rate of participants successfully completed the tasks when using the prefilled syringe, a newly approved epinephrine syringe for the treatment of anaphylaxis. These results indicated that the newly
Use of Dexamethasone in Prevention of the Second Phase or a Biphasic Reaction of Anaphylaxis Use of Dexamethasone in Prevention of the Second Phase or a Biphasic Reaction of Anaphylaxis - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more (...) studies before adding more. Use of Dexamethasone in Prevention of the Second Phase or a Biphasic Reaction of Anaphylaxis The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03523221 Recruitment Status : Recruiting First Posted
Missed Diagnosis of Anaphylaxis in Patients With Pediatric Urticaria in Emergency Department. This study was to determine the characteristics of missed diagnosis of pediatric anaphylaxis that were registered as urticaria only at the emergency department (ED) by comparing those who had only urticaria symptoms with those who had both anaphylaxis and urticaria symptoms.Subjects were classified into missed anaphylaxis and urticaria group according to whether satisfied anaphylaxis diagnostic (...) criteria or not. Anaphylaxis group, those who were initially registered as anaphylaxis with urticaria and anaphylaxis symptoms simultaneously, were further investigated.The missed anaphylaxis group included 37 patients of 1051 pediatric urticaria patients. The anaphylaxis group included 11 patients. The time from symptom onset to ED arrival in the missed anaphylaxis group was shorter than the urticaria group. More patients in the missed anaphylaxis group had a history of past food allergy. Seafood, egg
Food-induced fatal anaphylaxis: from epidemiological data to general prevention strategies. Anaphylaxis hospitalizations are increasing in many countries, in particular for medication and food triggers in young children. Food-related anaphylaxis remains an uncommon cause of death, but a significant proportion of these are preventable.To review published epidemiological data relating to food-induced anaphylaxis and potential risk factors of fatal and/or near-fatal anaphylaxis cases, in order (...) to provide strategies to reduce the risk of severe adverse outcomes in food anaphylaxis.We identified 32 published studies available in MEDLINE (1966-2017), EMBASE (1980-2017), CINAHL (1982-2017), using known terms and synonyms suggested by librarians and allergy specialists.Young adults with a history of asthma, previously known food allergy particularly to peanut/tree nuts are at higher risk of fatal anaphylaxis reactions. In some countries, cow's milk and seafood/fish are also becoming common triggers
Mucosal Injury From Calcium Oxalate Crystals Resembling Anaphylaxis and Angioedema. There are 215 families of plants that contain insoluble needle-shaped calcium oxalate crystals on the surface of their tissues. Upon mucosal contact, injury can cause extreme pain, soft-tissue swelling, salivation, dysphagia, and even aphonia. This presentation can resemble angioedema or anaphylaxis.A 55-year-old Asian female presented to the emergency department complaining of oral pain, swelling, and numbness (...) PHYSICIAN BE AWARE OF THIS?: Injury by calcium oxalate crystals is a relatively common occurrence that will present to the emergency department. Although most exposures are benign, patients can develop critical illness, requiring emergent therapies and airway management. Due to the nature of presentation, exposure can easily be misdiagnosed as anaphylaxis or hereditary and drug-induced angioedema. Severe pain and the temporal relationship to plant ingestion distinguish insoluble calcium oxalate crystal
Maternal anaphylactic shock in pregnancy: A case report. Anaphylaxis is a very rare event in pregnancy, triggering maternal hypotension leading to intrapartum hypoxic-ischemic encephalopathy in infant. Furthermore, cesarean sections are performed at a high rate in anaphylactic pregnant women.A 34-year-old pregnant woman presented with maternal anaphylaxis following prophylactic antibiotic injection for cesarean section. Within a few minutes after initiation of intradermal skin test (...) with cefotetan, the pregnant woman developed generalized itchy rash, chest tightness, and dyspnea.Several minutes after the injection of antibiotics, a diffuse urticarial rash was detected over her face and trunk followed by complaints of chest tightness and dyspnea. She was diagnosed with hypotension and hypoxia. Further, fetal heart tones showed bradycardia. A presumptive diagnosis of anaphylactic reaction induced by cefotetan was made for surgical prophylaxis.The patient was managed for anaphylaxis, via
A population-based epidemiological study of anaphylaxis using national big data in Korea: trends in age-specific prevalence and epinephrine use in 2010â€“2014 Previous reports on anaphylaxis in Asia are limited to relatively small-scale studies. We performed this study to identify the nationwide prevalence of anaphylaxis and epinephrine prescription rates by age groups.The total number of patients, yearly and overall prevalence, percentage of emergency department visits, and epinephrine (...) prescription rates were calculated for patients diagnosed with anaphylaxis based on the Korean National Health Insurance database from 2010 to 2014.The mean prevalence of anaphylaxis in Korea was 26.23 (95% confidence interval, CI 25.78-26.68) per 100,000 person-years during the 5 years. It increased from 20.55 (95% CI 20.15-20.10) in 2010 to 35.33 (95% CI 34.81-35.85) per 100,000 person-years in 2014. The average prevalence was > 35 per 100,000 person-years among 50-69 year-olds, and the mean crude
and antiseptics (chlorhexidine). All these substances (i.e. NMBA, anesthetics, antibiotics, latex devices) may cause severe systemic non-IgE-mediated reactions or fatal anaphylactic events even in the absence of any evident risk factor in the patient's anamnesis. For this reason, in order to minimize perioperative anaphylactic reactions, it is important to have rapid, specific, sensitive in vitro diagnostic tests able to confirm the clinical diagnosis of acute anaphylaxis. (...) Focus on the agents most frequently responsible for perioperative anaphylaxis Adverse reactions (ARs) to drugs administered during general anesthesia may be very severe and life-threatening, with a mortality rate ranging from 3 to 9%. The adverse reactions to drugs may be IgE and non-IgE-mediated. Neuromuscular blocking agents (NMBA) represent the first cause of perioperative reactions during general anesthesia followed by latex, antibiotics, hypnotic agents, opioids, colloids, dyes
Systemic and Local Anaphylaxis is Not Induced by Korean Red Ginseng Mixture in Guinea Pigs Currently, injuries to customers due to health functional foods are annually increasing. To evaluate the antigenicity of Korean red ginseng mixture (KRGM), we tested for systemic anaphylactic shock and passive cutaneous anaphylaxis in guinea pigs. Based on a comparison of measured body weights, there were no changes in body weight for the KRGM treatment group compared with the control group (...) . In the ovalbumin treated group, however, there was a statistically significant decrease in body weight. For the active systemic anaphylaxis test, after the induction, there were no symptoms that suggested anaphylactic shock in the control and KRGM treatment group. In the ovalbumin treated group, there were symptoms that suggested severe anaphylaxis, and those symptoms included restlessness, piloerection, tremor, rubbing or licking the nose, sneezing, coughing, hyperpnea, dyspnea, staggering gait, jumping
Emergency Management of Anaphylaxis: A High Fidelity Interprofessional Simulation Scenario to Foster Teamwork Among Senior Nursing, Medicine, and Pharmacy Undergraduate Students Nursing, medicine, and pharmacy students have limited opportunities during their undergraduate programs to learn and practice together as an interprofessional team. This has prompted faculty at Memorial University of Newfoundland to explore the use of high fidelity simulated interprofessional education (HF-IPE) to help (...) , and pharmacy students. The scenario is designed to promote an understanding of the roles of nursing, medical, and pharmaceutical professionals in an interprofessional team during the emergency management of an adult patient experiencing acute anaphylaxis. Teamwork and communication skills are emphasized, and students are provided with the opportunity to communicate and collaborate within an interprofessional healthcare team.
Fenugreek Anaphylaxis in a Pediatric Patient Fenugreek (Trigonella foenum-graecum) is a food product that belongs to the Leguminosae family along with other legumes. It has been used in India, Greece, and Egypt for culinary and medical purposes since ancient times, and today, fenugreek is used for flavoring foods, dyes, and drugs throughout the world. Many members of the Leguminosae family have been associated with allergies including soybean, green pea, and peanut. Fenugreek is also included (...) in this family and may result in allergic reactions. Two cases of anaphylaxis have been described in children after ingestion of curry and pastes that contain fenugreek, although the true nature of the causative agent was unclear. We report the first case of fenugreek anaphylaxis in a pediatric patient defined by skin testing, immunoglobulin E ImmunoCAP assays, and clear ingestion.
Emergency anaphylaxis protocols: A cross-sectional analysis of general practice surgeries and pharmacies in both the urban and rural setting in Ireland The incidence of anaphylaxis appears to be increasing worldwide with cases in the community outnumbering those in the hospital setting. General practice (GP) surgeries and pharmacies, based in the community, are often the first point of contact for many patients suffering from anaphylaxis.To determine if studied GP surgeries and pharmacies have (...) an anaphylaxis protocol on site and have access to an anaphylaxis kit; to explore GP's and pharmacists' personal experiences with management of anaphylaxis.A cross-sectional, questionnaire-based study was performed examining anaphylaxis protocols in a sample of general practices and pharmacies from some counties in Ireland. This consisted of a sample from rural and urban settings. The study commenced in October 2014.Nineteen of 24 GPs (79%) and 9 (29%) pharmacies had an anaphylaxis protocol (P < 0.001